quarta-feira, 7 de dezembro de 2011

Sex Addiction: The Null Hypothesis

You cannot prove sex addiction doesn't exist; it must be proven that it does.

Marnia Robinson
This post is a response to The Wages of Sexual-Addiction Politics by Marnia Robinson
I've recently begun to publish small excerpts and arguments from my forthcoming work, The Myth of Sex Addiction. As I've done so, I've heard from sex addiction proponents who argue that I must accept the tide of social opinion, that sex addiction is real. I suggest that they, and Ms. Robinson, are ignoring crucial tenets of the philosophy of science.
Michael Crichton said, "Whenever you hear the consensus of scientists agrees on something or other, reach for your wallet, because you're being had." If we are told that scientists and researchers and theorists are agreeing that sex addiction is real, despite there being no real empirical research to support it, I'm a bit worried, because it is a sign that something other than science is at play. I agree with Marnia Robinson that politics are at play here. We just disagree about which side they are playing on.

Thomas Kuhn was an American physicist and philosopher who changed our views of science, arguing that despite our beliefs that science moves on the basis of evidence, it in fact moves like all other human endeavors, on the basis of power and personality. He showed that when "paradigm shifts" occur—that is, major changes in understanding of science and scientific principles—they happen as a result of consensus between scientists, consensus that happens as critics are silenced or die out, not as a result of evidence piling up and finally convincing the critics they were wrong. One might begin to worry, then, that the constant pressure to add sex addiction as a diagnosis reflects less the influence of scientific research and more the influence of "consensus," powerful personalities, and agreement.
Karl Popper was also a philosopher of science, who saw the same problems that Kuhn did and attempted to help science resolve them. He created the structure known today as the "null hypothesis" and the argument that scientific work should be "falsifiable." In other words, scientists should not set out to prove themselves true but should set out to test whether they can prove their hypothesis is false. If a scientist cannot create an experiment that shows their hypothesis is false, then maybe it is true. But if they create an experiment that shows their hypothesis seems to be true, there are many different possibilities and unknown factors that could have led to that accidental verification.
Popper famously challenged the theories of psychoanalysis and Sigmund Freud, asserting that his theories were untestable. Science could not prove or disprove Freudian theories, because anytime that an answer or result didn't gibe with the predictions, then the field of psychoanalysis had many very clever, and equally untestable, alternate explanations waiting in the wings.
Sex addiction is not falsifiable, as currently identified. Because the theory is so vague and all inclusive, any challenges to the theory can be explained by reference to one of the alternate explanations. The definition of sex addiction includes both sexual excess as well as "sexual anorexia," defined as "behavior that is compulsively aversive to sexual activity." How can you argue against or disprove a diagnosis that encapsulates both the presence of a symptom and its absence? Historically, and in a similar vein, the diagnosis of nymphomania was once argued to include and be caused by both the inability of a woman to have an orgasm and a woman's multiorgasmic overresponsiveness to sexual stimulation!
When a person is "acting out" sexually, they're diagnosed with sex addiction. When a person who used to act out sexually is no longer acting out, without ever having received treatment, they are not pronounced cured but are instead labeled as being in the midst of a cyclical phase of attempting to control their behaviors.
Most sex addiction theories describe that addicts engage in sex to manage uncontrollable emotions, as a form of self-medication. But when studies offer evidence that there are addicts who in fact display little if any emotional pain, at least one response has been to suggest that the clients are emotionally numb, using sex to "break through" their numbness and feel something, even pain. Similarly, 19th century cereal magnate John Kellogg argued that masturbation resulted in either physical underdevelopment or overdevelopment. If a girl's breasts were too small or a boy's penis too large, both were clear signs that the child's physical development had been tainted by the corrupt influence of self-stimulation. When theories are fluid and unfalsifiable, it is easy to see what we expect, especially when the science is not working the way Kuhn suggested.
In the realm of scientific investigation, it is the responsibility of the believers to test and defend the validity of their hypothesis. If they cannot, then the null hypothesis, that the believers are wrong, is assumed to be true. Despite the challenges I have received as I criticize sex addiction, it is not my burden to prove that sex addiction doesn't exist. Instead, the field of sex addiction must prove scientifically that it does not. And to date, that proof is not forthcoming. Telling men with problems that they have sex addiction, and then having them become evangelists for sex addiction does not constitute proof. It is possible that investigations of hypersexual disorder may demonstrate proof that there is some kernel of truth here, but even that will not prove that there is an addictive process at work. Until then, the scientific answer is that sex addiction most likely does not exist, if it cannot be scientifically demonstrated. This is not science decreeing anything. In fact, in contrast to Ms. Robinson's assertion, this is not science working at a political level. Instead, this is the scientific process working as it should, to minimize the impact of human convictions and beliefs.
Finally, according to multiple individuals, sex addiction was not included in the DSM5 because of the poor science, not because of politics. Sex addiction was not included as a diagnosis in the addictive category due to lack of "empirical evidence," despite there being some usefulness to the concept, according to Dr. Martin Kafka. Sex addiction as an addictive disorder was declined by the DSM5 task force, along with problems related to shopping, working, and Internet use, all because of a serious lack of hard data, according to Charles O'Brien, MD, chair of the APA's DSM Substance-Related Disorders Work Group.


Nenhum comentário:

Postar um comentário